Not surprisingly, age is the single most important predictor of mortality and mor- bidity. As noted in Chapter 2, deaths during the first year of life were common in the United States until the 20th century. Although far less common now, infant mortality remains an important issue because so many years of productive life are lost when an infant dies and because infant mortality is often preventable.
Once individuals pass the danger zone during and immediately after birth, mortality rates drop precipitously. Those rates begin to rise significantly beginning at around age 40 and escalate with age. For those who survive past age 65, chronic diseases rather than acute diseases make up the major health problems, often bringing years of disability in their wake.
The American population is aging steadily, with the population above age 85 growing the fastest. Although most middle-aged and older persons are rela- tively healthy, rates of illness, disability, and mortality nevertheless are rising as the population ages. Similarly, both the total costs for health care and the percentage of health care dollars spent on the elderly—already greatly disproportionate to the size of that population—are bound to increase. At the same time, as young persons become a smaller proportion of the population, the pool of persons who can provide or pay for the care needed by the elderly is shrinking. Consequently, in the future, it will become more difficult to provide services to all the elderly persons who will need health care or assistance with daily tasks such as shopping or cooking.
These problems are amplified by the feminization of aging—the steady rise in the proportion of the population who are female in each older age group so that women constitute a larger proportion of the elderly than of the young and middle aged. Because elderly women more often than elderly men are poor and lack a spouse who can or will care for them and because (as we will see in the next section) women, in general, experience more illness than men, the feminization of aging will increase the costs of providing health and social services to the elderly.